AMSEC Musculoskeletal Competency Checklist

BASIC SCIENCE AND SUPPORTING KNOWLEDGEBiomedical sciences Understands the key basic biomedical science concepts and principles (including anatomy, physiology, pathology, pharmacology, microbiology, genetics and biostatistics), relates them to fundamental normal and abnormal processes in medicine throughout life, and applies them to the clinical sciences underlying current and emerging medical practice.

Local Learning Outcomes 1106.4 Predict the speed of locomotion of any terrestrial vertebrate on the basis of its limb morphologyIdentify and name the bones of the skeleton in any vertebrateDescribe, using correct anatomical terminology, the movements at joints of the body in terrestrial vertebrateIdentify, name and describe the action of major muscle groups in humans2202.1 Identify the surface landmarks and major bone points used in clinical examination2202.3 Define and discuss normal structure and function of the major joints in the body2202.6 Compare and contrast the structure, function and innervation of the upper and lower limbs2202.7 Identify and describe the anatomy of the head and neck2202.11 Describe physiological processing in motor and sensory pathways and the relationship to perceptual performance and motor sensory deficits and correlate with clinical testing, diagnosis and location of pathological processes2202.15 Describe and identify the macroscopic anatomy of the nervous system3343.12: Describe the pathogenesis, morphological and clinical manifestations of basic pathological processes and a range of specific diseases of the musculoskeletal systemDiscuss normal joint function.Discuss normal bone physiology, structure and histology.Describe the normal structure, function and metabolism of bones and joints.Discuss fracture healing and repair.4491: Apply anatomy, physiology, biochemistry, rheumatology and endocrinology knowledge to the musculoskeletal systemDescribe the normal anatomy of the musculoskeletal system

Learning experiences 1106: Lectures, Tutorials, Laboratories, Self directed learning2202: Lectures, Tutorials, Laboratories, Clinical skills3343: Lectures, Tutorials, Self directed learning4491: anatomy lab session

Assessment 1106: Practical/Clinical-Practical task, Written Assignment-Essay, Written Exam-Objective test items, Written Exam-Short Answer Questions2202: Oral-Presentation,  Practical/Clinical-Structured exam3343: Written Exam-Objective test items, Written Exam-Short Answer Questions4491: MCQ questions

AMSEC Musculoskeletal Competency Checklist – Version 2 (22/09/11) (+) – National Priority and High Burden Conditions; (*)–- MSK/Red Flag Emergencies

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Behavioural and Social Science Understands key concepts and principles of psychosocial development throughout life, the multitude of psychological and social factors influencing patient and professional behaviour and interactions, and applies these to the multiple domains of “professionalism” and the effective care of patients.

Local Learning Outcomes 2211.2 : Identify and discuss the causes of ill health considering both the national and international perspective4491 - Apply anatomy, physiology, biochemistry, rheumatology and endocrinology knowledge to the musculoskeletal systemDemonstrate effective clinical and interpersonal skills related to musculoskeletal disordersIdentify musculoskeletal somatisation as a manifestation of psychiatric disordersDescribe the progressive nature of deforming arthropathiesDescribe the psycho-social impact of deforming arthropathies on patients and their carersDemonstrate sensitivity to patients with problems of the musculoskeletal system who must frequently present with pain and disabilityDemonstrate awareness and sensitivity of patients with skeletal failure fractures and particularly proximal femoral fractures who often have associated dementia

Learning experiences 2211 Lectures, Tutorials, Clinical skillsIMED 4491 ward work, attendance at outpatient clinics

Assessment IMED 4491 workbook?2212 : Participation-Tutorials,  Written Assignment-Literature Review,  Written Assignment-Portfolio,  Written Assignment-Report, Written Assignment-Report,  Written Exam-Essay,  Written Exam-Short Answer Questions

Professionalism: Understands the core concepts and principles underlying the key non-technical” professional” roles in health including communicator, advocate, scholar, manager, leader, educator, collaborator, legal and ethical and relates these to the lifelong advancement of professional practice in health care.

Local Learning Outcomes Demonstrate effective clinical and interpersonal skills related to musculoskeletal disorderspersonal and professional development, 5th and 6th year

Learning experiences IMED 4491 ward work, attendance at outpatient clinics

Assessment IMED 4491 workbook?

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Specialized MSK: Understands the anatomical and basic science processes that underlie the normal form and function of specific MSK tissues throughout life including formation, maintenance and repair, calcium and phosphate metabolism and biomechanics as the basis for understanding and interpreting changes due to normal variation, ageing, abnormal forces and pathological conditions. Understands how the spectrum of pathological processes may affect MSK tissue; the specific reactions of MSK to disorders and injury; and how these may lead to deformity and dysfunction of bone and joints.

Local Learning Outcomes 1106.4 Describe, using correct anatomical terminology, the movements at joints of the body in terrestrial vertebrateIdentify, name and describe the action of major muscle groups in humans2202.2 Interpret radiographic (x-ray) images of the normal skeleton and CT and MRI images of the limbs, head and neck2202.3 Define and discuss normal structure and function of the major joints in the body3343.12: Describe the pathogenesis, morphological and clinical manifestations of basic pathological processes and a range of specific diseases of the musculoskeletal systemDiscuss normal joint function.Discuss normal bone physiology, structure and histology.Describe the normal structure, function and metabolism of bones and joints.Discuss fracture healing and repair.4491: Describe the pathophysiology of osteoporosis, osteomalacia, malignant bone disease and Paget's diseaseDescribe mechanisms of fracture and fracture healingDescribe mechanisms of tendon and ligament injury and healingDescribe mechanisms of nerve injuries and healingDescribe the pathophysiology of joint inflammation and joint degeneration and diffuse soft tissue painDescribe and explain calcium and phosphate related biochemistry

Learning experiences 2202 – lectures, tutorials, labs, clinical skillsIMED 3343: Lectures, tutorials, SDLIMED4491 ortho case study (trauma), PBLs (OP, RA)

Assessment IMED 3343: Summative and formative, written exam objective test items, short answer questions4491: self-assessment, oral presentation, practical skills, clinical structured exam, end of term MCQ

Imaging: Understands the fundamental concepts and principles associated with image production in the commonly used modalities; the resultant appearance of anatomical structures from these modalities; and identifies key radiological features and signs of normality as the basis for understanding and Interpreting changes due to normal variation, ageing, abnormal forces and pathological conditions. Understands how the spectrum of pathological processes are manifested in imaging studies; identifies specific reactions related to MSK disorders and injury; knows and interprets common signs of abnormality and deformity as well as commonly missed important fractures.

Local Learning Outcomes 2202.2 Interpret radiographic (x-ray) images of the normal skeleton and CT and MRI images of the limbs, head and neck2202.3 Define and discuss normal structure and function of the major joints in the body

AMSEC Musculoskeletal Competency Checklist – Version 2 (22/09/11) (+) – National Priority and High Burden Conditions; (*)–- MSK/Red Flag Emergencies

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Learning experiences 2202: lectures, tutorials, labs, clinical skills4491: lecture on general fracture principle, tOSCE presentation on dx imaging, ortho case study (fracture), ortho case study (mets), ward and outpatient experiences

Assessment 4491: MSK online self-assessments, end-of-year OSCE exams, end of term MCQ, clinical structured exam, oral presentation

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CLINICAL SCIENCES AND SKILLSAttitude and Communication Skills: Incorporates key concepts and principles of “Behavioural and Social Science” and “Professionalism” as the basis for effective communication (using both verbal and non-verbal techniques) with patients, their friends and families, health professionals and the general public. This includes collecting and conveying information clearly, considerately and sensitively and listening and responding to patient concernsLocal Learning Outcomes

Demonstrate effective clinical and interpersonal skills related to musculoskeletal disorders3rd yr GP, 5th yr GP, personal and professional development, 5th and 6th year

Learning experiences

Mentor discussions, ward work and outpatient clinics

Assessment PPD portfolio

Assessment: Able to communicate effectively with a patient and/or representative to construct an accurate and problem focussed MSK history, relate this to abnormalities identified by appropriately targeted physical examination and investigations, and interpret using the principles of critical reasoning and diagnostic formulation with consideration to any impairments, disabilities and/or functional limitations.

History1. Demonstrates ability to perform accurate and organized MSK screening2. Demonstrates ability to take accurate and organized MSK problem-focussed

history in the following presentations:a. Acute pain presentationb. Chronic pain presentationc. Traumatic injury presentationd. Functional disability presentation

3. Demonstrates understanding of general pathological processes and specific reactions of MSK tissues to disorders and injuries

Local Learning Outcomes

3345.42.2 Discuss the general principles of pain management3345.42.3 Discuss the role of drugs in the overall management of chronic pain3345.2.4 Discuss the problems arising from drug use in patients with chronic pain3345.2.5 Be aware of the major practical issues in managing chronic pain4491.3.1 Describe the clinical assessment and management of complaints of musculoskeletal pain including myalgia, arthralgia, arthritis and back pain.4491.3.12Describe and explain the pathological features, clinical assessment and management of common orthopaedic injuries of wrist,ankle, femoral neck, soft tissue (knee and shoulder), elbow, clavicle, hand (including nerve, tendon, bone injury and loss of function)5531.5.4 Conduct a consultation including taking a history, requesting and interpreting appropriate investigations, formulating a diagnosis and a management plan with a patient presenting with low back pain, neck pain, knee pain and headacheIdentify common causes of low back pain, neck pain and knee pain, and of chronic headache in general practice5531.5.16 – broad mgmt. of chronic pain

Learning experiences

3345 – tutorials, case based learning4491 ward work and outpatient clinics, PBLs for rheumatology, ortho case studies, general fracture and polytrauma lectures

Assessment 4491 workbook, end of term MCQ, 3345 written exam short answer, MCQ

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Examination(a) Applies physical examination principles to MSK physical examinations(b) Able to perform general screening examinations (e.g. GALS)(c) Able to perform systematic examination for inflammatory conditions(d) Able to perform examinations in acute trauma settings(e) Able to perform regional examinations of the spine and extremities(f) Able to apply principles of critical reasoning to examination findings(g) Understands effect of validity, sensitivity and specificity to interpretation of

MSK examination findings(h) Considers effect of acute pain on performance and interpretation of MSK

examination findings(i) Considers effect of chronic pain on performance and interpretation of MSK

examination findings(j) Considers effect of psychosocial “yellow flags” on performance and

interpretation of MSK examination findingsLocal Learning Outcomes

2211.13.4 Describe and demonstrate regional physical examinations of the musculoskeletal system with the use of appropriate tools and techniques4491. 3: Describe and explain the pathological features, clinical assessment and management of specific musculoskeletal related health conditions 4491.4.1: Perform examination of peripheral joints and the back/spine, hip, shoulder and neck accurately and efficiently4491.4.2: Perform examination of frequently problematic soft tissue structures accurately and efficiently4491 3.4.2.1 Demonstrate how clinical examination and functioning tests relate to the anatomy and physiology of the musculoskeletal system5531.5.4 Conduct a consultation including taking a history, requesting and interpreting appropriate investigations, formulating a diagnosis and a management plan with a patient presenting with low back pain, neck pain, knee pain and headache

Learning experiences

2211 – tutorials, clinical skills4491: physical examination tutorials week 1, ward work and outpatient clinics5531: Tutorials, Problem based learning, Lectures, Clinical skills, Placement

Assessment 2211: Practical/Clinical-Observed encounter, Portfolio, Workbook/lab book, Essay, Short Answer Questions4491: workbook, end of term MCQ, MEQ5531: Practical/Clinical-Simulation, Written Assignment-Log BookInvestigations4. Demonstrates the appropriate selection of the following investigative modalities for

MSK conditions, with consideration of risk/benefit ratio, accessibility, cost effectiveness, validity, sensitivity and specificity:

a. Laboratory testsb. Imaging modalitiesc. Special diagnostic modalities

Local Learning Outcomes

2202.2: Interpret radiographic (x-ray) images of the normal skeleton and CT and MRI images of the limbs, head and neck4491.4.4.1.4 Describe how to order and accurately interpret synovial fluid laboratory studiesDescribe how to order and accurately interpret bone densitometry5531.5.4 Conduct a consultation including taking a history, requesting and interpreting appropriate investigations, formulating a diagnosis and a management plan with a patient presenting with low back pain, neck pain, knee pain and headache

Learning experiences

2202: Lectures, Tutorials, Laboratories, Clinical skills4491 lectures (OA – joint aspiration), (laboratory tests), ortho case study5531: Tutorials, Problem based learning, Lectures, Clinical skills, Placement

Assessment 2202: Oral-Presentation, Practical/Clinical-Structured exam4491 – MCQ5531: Practical/Clinical-Simulation, Written Assignment-Log Book

AMSEC Musculoskeletal Competency Checklist – Version 2 (22/09/11) (+) – National Priority and High Burden Conditions; (*)–- MSK/Red Flag Emergencies

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Critical Reasoning and Diagnostic Formulation: Relates MSK problem-based assessment findings to anatomical and pathological aetiologies; recognizes features used to discriminate between specific MSK conditions (ie understands differential diagnosis of MSK conditions); and applies the principles of critical reasoning and diagnostic formulation in the construction of appropriate differential diagnosisLocal Learning Outcomes

IMED 4491 4.4.1.3: Describe and explain the pathological features, clinical assessment and management of specific musculoskeletal related health conditionsIMED 5531 Conduct a consultation including taking a history, requesting and interpreting appropriate investigations, formulating a diagnosis and a management plan with a patient presenting with low back pain, neck pain, knee pain and headache

Learning experiences

IMED 4491 lectures, including intro lecture, ward and outpatient clinic attendance5531: Tutorials, Problem based learning, Lectures, Clinical skills, Placement

Assessment IMED 4491 MCQ, IMED 4491 workbook5531: Practical/Clinical-Simulation, Written Assignment-Log Book

Related Management Issues: Understands the key broader community, legal, environmental and technical issues that may impact on the management of individual patient.Local Learning Outcomes

4491.2.3 Describe the psycho-social impact of deforming arthropathies on patients and their carers4491.6.1 Identify and describe the high incidence and prevalence of low back pain in the community and the issues of continuing care for chronic disorder4491.6.2 Identify and describe the scope for prevention of musculoskeletal disorders such as gout, viral arthritis and osteoporosis

Learning experiences

4491 lectures, PBLs

Assessment 4491 end-of-term MCQ

Procedural Skills: Understands the general principles of safe procedural performance and equipment usage, and is able to perform procedures or use equipment at the prescribed level, (including limb realignment, splintage and injection use in MSK conditions).Local Learning Outcomes

4491.4.3 Perform safe application and removal of a forearm plaster backslab4491.4.4 Perform safe application of a triangular broad arm sling, a collar and cuff shoulder sling4491.4.5 Describe how to order and accurately interpret synovial fluid laboratory studies4491.4.6 Describe how to order and accurately interpret bone densitometry4491.4.7 Describe the indications for use of a triangular broad arm sling, a collar and cuff shoulder sling

Learning experiences

4491 lectures (gout, OP), PBL (OP)

Assessment 4491 end of term MCQ

Prioritization: Understands the principles of prioritizing conditions in health and education (both professional and patient) based on urgency, frequency and amenable to intervention. This incorporates factors such as the impact on the individual patient, the community and the population, financial resources, incidence, prevalence, projected changes and emerging issues.Local Learning Outcomes

Learning experiences

Assessment

Management:

AMSEC Musculoskeletal Competency Checklist – Version 2 (22/09/11) (+) – National Priority and High Burden Conditions; (*)–- MSK/Red Flag Emergencies

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Understands the key principles of management of conditions that have a broad application across health including pain, wound management and general trauma.

Local Learning Outcomes

4491.3: Describe and explain the pathological features, clinical assessment and management of specific musculoskeletal related health conditions5531.5.4 Conduct a consultation including taking a history, requesting and interpreting appropriate investigations, formulating a diagnosis and a management plan with a patient presenting with low back pain, neck pain, knee pain and headache

Learning experiences

IMED 4491 lectures, PBLs, case studies, ward and outpatient clinics5531: Tutorials, Problem based learning, Lectures, Clinical skills, Placement

Assessment IMED 4491 end-of-term MCQ, MEQ, OSCE5531: Practical/Clinical-Simulation, Written Assignment-Log Book

Management:Understands the general and related patient management modalities and describes their application in the holistic management of MSK conditions including therapeutic (operative and non-operative); rehabilitiation; patient education and self-management, shared care and referral; prevention; and complementary and alternative medicine modalities.

Local Learning Outcomes

4491.5.1 Describe and explain the role of ancillary health professionals, e.g. physiotherapists, occupational therapists, and podiatrists in the acute and chronic care of musculoskeletal disease.

Learning experiences

4491: t-OSCE, ward and outpatient clinics

Assessment

Management:Applies knowledge of general and MSK related basic and clinical science to describe the basic aetiology, pathogenesis, characteristics clinical manifestations and general principles of assessment and management for patients suffering from the broad range of MSK-related conditions and disorders. This includes the management of normal variation and special concern groups. Knowledge of specific conditions should be prioritized in detail towards the management of the “MSK/red-flag emergencies” and the national priority and high burden MSK conditions.Local Learning Outcomes

4491.3: Describe and explain the pathological features, clinical assessment and management of specific musculoskeletal related health conditions

Learning experiences

4491: lectures, PBLs, ortho case studies, ward and inpatient experience

Assessment 4491: end of term MCQ, MEQ

AMSEC Musculoskeletal Competency Checklist – Version 2 (22/09/11) (+) – National Priority and High Burden Conditions; (*)–- MSK/Red Flag Emergencies

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AMSEC Priority Ambulatory Conditions – Spine/Chest

Local Learning Outcomes Learning Experiences Assessment

Vertebral fractures IMED 4491.4.4.1.3 Describe and explain the pathological features, clinical assessment and management of spinal injury including soft tissue and bone

IMED 4491 spinal fracture lecture, PBL OP

IMED 4491 MCQ

Non-specific pain/strain 5531.5.4 Conduct a consultation including taking a history, requesting and interpreting appropriate investigations, formulating a diagnosis and a management plan with a patient presenting with low back pain, neck pain, knee pain and headache

5531: Tutorials, Problem based learning, Lectures, Clinical skills, Placement

5531: Practical/Clinical-Simulation, Written Assignment-Log Book

Spinal pain : Localized, with somatic referred pain, with radicular pain +/- radiculopathy (+)

5531.3 Describe and explain the epidemiology, natural history and pathogenesis of vertebral dysfunction, with reference to facet joint pain and disc protrusion, to a patient in a consultation setting

IMED 4491 online lecture back pain5531: Tutorials, Problem based learning, Lectures, Clinical skills, Placement

5531: Practical/Clinical-Simulation, Written Assignment-Log Book

Degenerative spinal conditions

IMED 3343 - Discuss pathological and relevant clinical aspects of osteoarthritis.

IMED 4491 online lecture back pain

IVD IMED 3343- Demonstrate knowledge of spinal degenerative disc disease and spondylosis.

IMED 4491 online lecture back pain

Facet joint IMED 4491.3.10 Describe and explain the pathological features, clinical assessment and management of osteoarthritis - both generalized and local osteoarthritis, including facet joint dysfunction5531.3 Describe and explain the epidemiology, natural history and pathogenesis of vertebral dysfunction, with reference to facet joint pain and disc protrusion, to a patient in a consultation setting

IMED 4491 online lecture back pain5531: Tutorials, Problem based learning, Lectures, Clinical skills, Placement

5531: Practical/Clinical-Simulation, Written Assignment-Log Book

Spinal stenosis IMED 4491 online lecture back pain IMED 4491 MCQ

Cauda equina syndrome (*)

Failed back syndrome

Metastatic disease IMED 3343 - Demonstrate a basic understanding of pathological aspects of bony metastasis and multiple myeloma.

3343: Lectures, Tutorials, Self directed learning4491: ortho case study

3343: Written Exam-Objective test items, Written Exam-Short Answer Questions

AMSEC Musculoskeletal Competency Checklist – Version 2 (22/09/11) (+) – National Priority and High Burden Conditions; (*)–- MSK/Red Flag Emergencies

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Spondylolysis/ spondylolisthesis

IMED 3343- Demonstrate knowledge of spinal degenerative disc disease and spondylosis.

3343: Lectures, Tutorials, Self directed learningIMED 4491 online lecture back pain

3343: Written Exam-Objective test items, Written Exam-Short Answer Questions

Diffuse idiopathic skeletal hyperostosis (DISH)

AMSEC Musculoskeletal Competency Checklist – Version 2 (22/09/11) (+) – National Priority and High Burden Conditions; (*)–- MSK/Red Flag Emergencies

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AMSEC Priority Ambulatory Conditions – Spine/Chest

Local Learning Outcomes Learning Experiences Assessment

RA neck manifestations (+) 3343 - Demonstrate knowledge of pathological and relevant clinical aspects of rheumatoid arthritis and rheumatoid disease.5531.3.19 - Describe the epidemiology, natural history and pathogenesis of arthritis (osteoarthritis and rheumatoid arthritis) to a patient in a consultation setting4491.4.4.1.3 Describe and explain the pathological features, clinical assessment and management of early rheumatoid arthritisDescribe and explain the pathological features, clinical assessment and management of late rheumatoid arthritis

3343: Lectures, Tutorials, Self directed learning4491: RA self assessments

3343: Written Exam-Objective test items, Written Exam-Short Answer Questions

Costochondritis

Sternoclavicular joint pain

Scoliosis 4491: low back lecture

Kyphosis 4491: low back lecture

Torticollis

Discitis (*)

AMSEC Musculoskeletal Competency Checklist – Version 2 (22/09/11) (+) – National Priority and High Burden Conditions; (*)–- MSK/Red Flag Emergencies

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AMSEC Priority Ambulatory Conditions – Hip/Pelvis

Local Learning Outcomes Learning Experiences Assessment

Hip and Pelvic ring fractures(*? – injury w/ visceral)

IMED 4491 hip lecture IMED 4491 MCQ

Degenerative joint disease (DJD)/OA (+)

IMED3343 - Demonstrate knowledge of osteo-arthritis and septic arthritis including diagnosis and principles of management

3343: Lectures, Tutorials, Self directed learningIMED 4491 online lecture back pain

3343: Written Exam-Objective test items, Written Exam-Short Answer QuestionsIMED 4491 MCQ

Sacroiliac (SI) joint dysfunction/arthropathy

4491 seronegative spondyloarthropaty lecture

Greater trochanteric bursitis IMED 4491 hip lecture

Hip insertional tendinopathies (gluteal, adductor)

IMED 4491 hip lecture

Piriformis syndrome

Avascular necrosis (AVN) IMED 3343- Discuss avascular/aseptic necrosis. IMED 4491 hip lecture

Snapping hip

Transient synovitis of the hips

IMED 4491 paediatric ortho lecture IMED 4491 MCQ

Slipped capital femoral epiphysis (SCFE)

IMED 4491 paediatric ortho lecture IMED 4491 MCQ

Perthes disease IMED 4491 paediatric ortho lecture IMED 4491 MCQ

Developmental dysplasia of the hip (DDH)

IMED 4491 paediatric ortho lecture IMED 4491 MCQ

AMSEC Musculoskeletal Competency Checklist – Version 2 (22/09/11) (+) – National Priority and High Burden Conditions; (*)–- MSK/Red Flag Emergencies

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AMSEC Priority Ambulatory Conditions – Knee/Leg

Local Learning Outcomes Learning Experiences Assessment

Tibial plateau fractures

Patellofemoral pain syndrome 4491: knee lecture

Degenerative joint disease/osteoarthritis (+)

IMED 4491 knee lecture IMED 4491 MCQ

Cruciate ligament (ACL/PCL) tear

IMED 4491 knee lectureIMED 4491 week 1 phys exam review sessions

IMED 4491 MCQ

Collateral ligament (LCL/MCL) tear

IMED 4491 knee lectureIMED 4491 week 1 phys exam review sessions

IMED 4491 MCQ

Mensicus tears IMED 4491 knee lectureIMED 4491 week 1 phys exam review sessions

IMED 4491 MCQ

Popliteal cyst IMED 4491 knee lecture

Iliotibial band syndrome (ITBS)

Osgood-Schlatter’s disease 4491: paeds rheumatology session

Patellofemoral dislocation/instability

IMED 4491 knee lectureIMED 4491 week 1 phys exam review sessions

Tendinopathies (patellar/quadriceps)

IMED 4491 knee lecture

Medial tibial stress syndrome (shin splints)Tibial stress fracture

Compartment syndrome of leg (*)

4491 – general fracture lecture, ortho case study, sef-assessments

Genu valgum IMED 4491 knee lecture IMED 4491 MCQ

Genu varum IMED 4491 knee lecture IMED 4491 MCQ

AMSEC Musculoskeletal Competency Checklist – Version 2 (22/09/11) (+) – National Priority and High Burden Conditions; (*)–- MSK/Red Flag Emergencies

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AMSEC Priority Ambulatory Conditions – Ankle/Foot

Local Learning Outcomes Learning Experiences Assessment

Ankle fractures

Stress fractures

Ankle sprains

TMT ligament injuries

Achilles tendon rupture

Ankle and subtalar arthritis

Plantar fasciitis 4491: Describe and explain the pathological features, clinical assessment and management of common soft tissue disorder e.g. rotator cuff tendonitis, epicondylitis, carpal tunnel syndrome, plantar fasciitis, tenosynovitis, Dupuytrens contracture, Ganglia

Achilles tendinosis/posterior heel pain

Bruised heel pad

Posterior tibial tendon dysfunction

Corns and calluses

Metatarsalgia

Hallux valgus (bunion)

Hallux rigidus

Interdigital neuroma

Diabetic foot 5531.5 Conduct a consultation including taking a history, requesting and interpreting appropriate investigations, formulating a diagnosis and a management plan with a

5531: Tutorials, Problem based learning, Lectures, Clinical skillsPlacement

5531: Oral-Presentation, Practical/Clinical-Observed encounter4481: Participation-Attachment Rating,

AMSEC Musculoskeletal Competency Checklist – Version 2 (22/09/11) (+) – National Priority and High Burden Conditions; (*)–- MSK/Red Flag Emergencies

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patient presenting with diabetes4481.5.8 List and describe the principles for diagnosing and managing chronic wounds especially venous ulcers, diabetic foot ulcers, arterial ulcers and pressure ulcers6681.5.8 Integrate knowledge of the principles for diagnosing and managing chronic wounds especially venous ulcers, diabetic foot

5561: PBL diabetes4481: Self directed learning, Placement, Discussions, Clinical assessment of a patient6681: Self directed learning, Placement, Discussions, Clinical assessment of a patient

Participation-Problem Based Learning, Written Assignment-Short Answer Questions, Written Assignment-Workbook/lab book6681: Participation-Attachment Rating, Participation-Problem Based Learning, Written Assignment-Short Answer Questions, Written Assignment-Workbook/lab book

Toe deformities

AMSEC Musculoskeletal Competency Checklist – Version 2 (22/09/11) (+) – National Priority and High Burden Conditions; (*)–- MSK/Red Flag Emergencies

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AMSEC Priority Ambulatory Conditions – Ankle/Foot

Local Learning Outcomes Learning Experiences Assessment

Plantar warts

Ingrown toenail

Intoeing/Outtoeing

Flat foot

Calcaneal aphophysitis

Cavus foot

Toewalking

AMSEC Musculoskeletal Competency Checklist – Version 2 (22/09/11) (+) – National Priority and High Burden Conditions; (*)–- MSK/Red Flag Emergencies

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AMSEC Priority Ambulatory Conditions – Shoulder

Local Learning Outcomes Learning Experiences Assessment

Proximal humeral fracture 4491: ortho case study, shoulder lecture, upper and lower limb injuries, self-assessments

Clavicle fracture 4491: ortho case study, shoulder lecture, upper and lower limb injuries, self-assessments

ACJ injuries 4491: ortho case study, shoulder lecture, upper and lower limb injuries, self-assessments

Rotator cuff pathology (tear/strain/tendinopathy)

Describe and explain the pathological features, clinical assessment and management of common soft tissue disorder e.g. rotator cuff tendonitis, epicondylitis, carpal tunnel syndrome, plantar fasciitis, tenosynovitis, Dupuytrens contracture, Ganglia

4491: Shoulder lecture 4491: MCQ

Impingement syndrome 4491: Shoulder lecture

Adhesive capsulitis/frozen shoulder

4491: Shoulder lecture 4491: MCQ

Subacromial bursitis 4491: Shoulder lecture

Shoulder arthritis/OA (+) 4491: Shoulder lecture 4491 MCQ

Proximal biceps rupture/tendinopathy

4491: Shoulder lecture

Shoulder instability/shoulder dislocation (*)

4491: ortho case study, shoulder lecture, upper and lower limb injuries

4491 MCQ

Thoracic outlet syndrome

SLAP lesions

Brachial plexus injuries (*)

AMSEC Musculoskeletal Competency Checklist – Version 2 (22/09/11) (+) – National Priority and High Burden Conditions; (*)–- MSK/Red Flag Emergencies

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AMSEC Priority Ambulatory Conditions – Wrist/hand/

elbow

Local Learning Outcomes Learning Experiences Assessment

Distal radial fracture 4491: upper and lower limb injuries lecture, ortho case study

Radial head fracture 4491: upper and lower limb injuries lecture, ortho case study

Elbow dislocation

Wrist sprain

Scaphoid fracture 4491: hand lecture

Keinbock’s disesase 4491: hand lecture

Supracondylar fracture (children) (*)

4491: paediatric ortho lecture IMED 4491 MCQ

Nursemaid’s elbow (radial head subluxation)Metacarpal and finger fractures

4491: hand lecture

Hand/wrist lacerations 4491: hand lecture

Flexor tendon injuries 4491: hand lecture

Mallet finger 4491: hand lecture

Nail bed injuries 4491: hand lecture

Flexor tendon sheath infections

4491: hand lecture

Human bites

Carpal tunnel syndrome Describe and explain the pathological features, clinical assessment and management of common soft tissue disorder e.g. rotator cuff tendonitis, epicondylitis, carpal tunnel syndrome, plantar fasciitis, tenosynovitis, Dupuytrens contracture, Ganglia

4491: hand lecture

AMSEC Musculoskeletal Competency Checklist – Version 2 (22/09/11) (+) – National Priority and High Burden Conditions; (*)–- MSK/Red Flag Emergencies

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AMSEC Priority Ambulatory Conditions – Wrist/hand/

elbow

Local Learning Outcomes Learning Experiences Assessment

Nerve entrapments (ulnar nerve)

4491: hand lecture

Wrist ganglions 4491: hand lecture

Epicondylitis (lateral and medial)

Describe and explain the pathological features, clinical assessment and management of common soft tissue disorder e.g. rotator cuff tendonitis, epicondylitis, carpal tunnel syndrome, plantar fasciitis, tenosynovitis, Dupuytrens contracture, Ganglia

4491: self-assessments

Olecranon bursitis

Thumb CMC DJD 4491: hand lecture

DeQuervain’s tenosynovitis

Dupuytren disease Describe and explain the pathological features, clinical assessment and management of common soft tissue disorder e.g. rotator cuff tendonitis, epicondylitis, carpal tunnel syndrome, plantar fasciitis, tenosynovitis, Dupuytrens contracture, Ganglia

4491: hand lecture

Trigger finger 4491: hand lecture

AMSEC Musculoskeletal Competency Checklist – Version 2 (22/09/11) (+) – National Priority and High Burden Conditions; (*)–- MSK/Red Flag Emergencies

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AMSEC Priority Ambulatory Conditions – Rheumatologic

conditions

Local Learning Outcomes Learning Experiences Assessment

Osteoarthritis (+) IMED3343 - Discuss pathological and relevant clinical aspects of osteoarthritisIMED 4491.3.10 - Describe and explain the pathological features, clinical assessment and management of osteoarthritis - both generalized and local osteoarthritis, including facet joint dysfunction.IMED 5531.3.16 - Describe and explain the epidemiology, natural history and pathogenesis of osteoarthritis especially affecting the spine (lumbar + cervical) and knee to a patient in a consultation setting

3343: Lectures, Tutorials, Self directed learning

IMED4491 OA lectureIMED 4491 hip lectureIMED 4491 knee lectureIMED 4491 tOSCE

3343: Written Exam-Objective test items, Written Exam-Short Answer Questions

IMED 4491 MCQ

Rheumatoid arthritis (+) IMED 3343 - Demonstrate knowledge of pathological and relevant clinical aspects of rheumatoid arthritis and rheumatoid disease.IMED 5531.3.19 - Describe the epidemiology, natural history and pathogenesis of arthritis (osteoarthritis and rheumatoid arthritis) to a patient in a consultation settingIMED 4491.4.4.1.3 Describe and explain the pathological features, clinical assessment and management of early rheumatoid arthritisDescribe and explain the pathological features, clinical assessment and management of late rheumatoid arthritis

3343: Lectures, Tutorials, Self directed learning

IMED 4491 RA lectureIMED 4491 PBL

3343: Written Exam-Objective test items, Written Exam-Short Answer Questions

IMED 4491 MCQ

Juvenile idiopathic arthritis (+)

IMED 4491 tutorial session paediatric rheumatology

IMED 4491 MCQ

Reactive arthritis IMED 4491 seronegative spondyloarthropathy lecture

IMED 4491 MCQ

Crystal arthropathy (gout, pseudogout)

IMED 3343 - Demonstrate knowledge of pathological and relevant clinical aspects of crystal arthropathies including gout and calcium pyrophosphate diseaseIMED 4491.4.4.1.3 - Describe and explain the pathological features, clinical assessment and management of gout and other crystal arthropathiesIMED 4491.11.4.1 Identify and describe the scope for prevention of musculoskeletal disorders such as gout, viral arthritis and osteoporosis

3343: Lectures, Tutorials, Self directed learning

IMED 4491 gout lecture

3343: Written Exam-Objective test items, Written Exam-Short Answer Questions

IMED 4491 MCQ

Idiopathic inflammatory myositis

Psoriatic arthritis IMED 4491 seronegative spondyloarthropathy lecture

IMED 4491 MCQ

AMSEC Musculoskeletal Competency Checklist – Version 2 (22/09/11) (+) – National Priority and High Burden Conditions; (*)–- MSK/Red Flag Emergencies

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Spondyloarthropathies 4491.3: Describe and explain the pathological features, clinical assessment and management of specific musculoskeletal related health conditions

4491: seronegative spondyloarthropathy lecture

4491 MCQ

Polymyalgia rheumatica 4491: autoimmune and CTD disease

Temporal arteritis (*) 4491: autoimmune and CTD disease

Lupus 4491: autoimmune and CTD disease 4491 MCQ

Scleroderma 4491: autoimmune and CTD disease 4491 MCQ

Other autoimmune/CTD 4491: autoimmune and CTD disease 4491 MCQ

AMSEC Musculoskeletal Competency Checklist – Version 2 (22/09/11) (+) – National Priority and High Burden Conditions; (*)–- MSK/Red Flag Emergencies

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AMSEC Priority Ambulatory Conditions – General and

other conditions

Local Learning Outcomes Learning Experiences Assessment

Osteoporosis (+)

2211.2.3 Describe in detail the pathological and clinical features of diseases/conditions including diabetes, osteoporosis, breast cancer, HRT, contraception, renal disease, arthritis, depression, vision and hearing loss2211.10.4 Describe major stages of cognitive, social, and physical development in the different life stages and how this relates to health behaviour for examples such as childhood obesity, eating disorders, dementia, arthritis and osteoporosis 3311.8.4 Describe major stages of cognitive, social, and physical development in the different life stages and how this relates to health behaviour for examples such as childhood obesity, eating disorders, dementia, arthritis and osteoporosis3343.12.20 Discuss the major types of metabolic bone disease, in particular, osteoporosis, osteomalacia/rickets, hyperparathyroidism and Paget's disease of bone.3345.33.3Drugs affecting bone and calcium metabolism: Describe the treatment options available in osteoporosis3345.33.5 Drugs affecting bone and calcium metabolism: Describe the potential roles of calcium, vitamin D analogues, bisphosphonates and other drugs in managing osteoporosis4491.4.4.1.3 Describe and explain the pathological features, clinical assessment and management of osteoporosis including hypogonadism, age-related, glucocorticoid and geneticList and select appropriate analgesics, anti-rheumatic drugs, drugs used in infection and metabolic bone disease, providing reasons for choices, under supervisionList common adverse reactions to analgesics, anti-rheumatic drugs, drugs used in infection and metabolic bone disease4491.11.4.1 Identify and describe the scope for prevention of musculoskeletal disorders such as gout, viral arthritis and osteoporosis

3343: Lectures, Tutorials, Self directed learning3345: lectures4491 OP lecture, OP PBL, laboratory tests/biochemistry

3343: Written Exam-Objective test items, Written Exam-Short Answer Questions3345: Objective test items, Short Answer Questions4491: MCQ

Paget’s disease 3343.12.20 Discuss the major types of metabolic bone disease, in particular, osteoporosis, osteomalacia/rickets, hyperparathyroidism and Paget's disease of bone.4491.1.3 Describe the pathophysiology of osteoporosis, osteomalacia, malignant bone disease and Paget's disease

3343: Lectures, Tutorials, Self directed learning

IMED 4491 biochemistry

3343: Written Exam-Objective test items, Written Exam-Short Answer Questions

IMED 4491 MCQ

AMSEC Musculoskeletal Competency Checklist – Version 2 (22/09/11) (+) – National Priority and High Burden Conditions; (*)–- MSK/Red Flag Emergencies

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Fibromyalgia

Child abuse 4491: paeds rheumatology session, paeds ortho lecture

Complex regional pain syndrome

Compartment syndrome (*) IMED 4491.4.4.1.3 Describe and explain the pathological features, clinical assessment and management of compartment syndrome and crush syndrome

IMED 4491 ortho case study

Open fractures (*) IMED 3343 - Discuss fracture healing and repair 3343: Lectures, Tutorials, Self directed learning

IMED 4491 ortho case study

3343: Written Exam-Objective test items, Written Exam-Short Answer Questions

MSK mimickers/red flags (*)

Infections of MSK tissues (bone/joint/muscle, etc) (*)

IMED3343Demonstrate knowledge of osteo-arthritis and septic arthritis including diagnosis and principles of managementDemonstrate knowledge of pathological and relevant clinical aspects of osteomyelitis.IMED 4491.4.4.1.3 Describe and explain the pathological features, clinical assessment and management of septic arthritisDescribe and explain the pathological features, clinical assessment and management of osteomyelitis

3343: Lectures, Tutorials, Self directed learning

IMED 4491 case study

3343: Written Exam-Objective test items, Written Exam-Short Answer Questions

Tumours of MSK tissues (*) 3343.12.9 Give a classification of bone tumours.3343.12.10 Describe general clinical aspects of bone tumours.3343.12.11 Demonstrate a basic understanding of pathological aspects of bony metastasis and multiple myeloma.3343.12.12 Describe osteochondroma.3343.12.13 Discuss pathological and relevant clinical features of osteosarcoma, chondrosarcoma, giant cell tumour of bone3343.12.16 Demonstrate an understanding of the nature and complexity of the neoplasms and pseudoneoplastic processes which can arise in soft tissue, with particular reference to their presentation, growth patterns and clinical course.3343.12.17 Demonstrate an understanding of the fundamentals of clinical staging and the approach to biopsy

3343: Lectures, Tutorials, Self directed learning4491 case study, self assessments

3343: Written Exam-Objective test items, Written Exam-Short Answer Questions

AMSEC Musculoskeletal Competency Checklist – Version 2 (22/09/11) (+) – National Priority and High Burden Conditions; (*)–- MSK/Red Flag Emergencies

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diagnosis as applied to musculoskeletal system tumours4491.4.4.1.3 Describe and explain the pathological features, clinical assessment and management of neoplastic bone disease

AMSEC Musculoskeletal Competency Checklist – Version 2 (22/09/11) (+) – National Priority and High Burden Conditions; (*)–- MSK/Red Flag Emergencies

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Summary of Level of Integration between AMSEC Competencies and UWA MBBS Curriculum

Basic Science and Supporting Knowledge

Competencies(n = 5)

Clinical Sciences and Skills Competencies

(n = 11)

Priority Ambulatory Conditions(n = 130)

National Priority and High Burden Conditions

(n=9)

MSK/Red Flag

Conditions(n = 13)

Level of Coverage(# = number of levels –

outcomes, learning experiences, assessment; v

= vertical integration present)3 + V 4 5 11 6 1

3 0 2 4 0 02 + V 1 0 5 0 1

2 0 1 28 3 51 + V 0 0 0 0 0

1 0 0 35 0 20 0 1 47 0 4

AMSEC Musculoskeletal Competency Checklist – Version 2 (22/09/11) (+) – National Priority and High Burden Conditions; (*)–- MSK/Red Flag Emergencies

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